Individual
ANTOINETTE ITOKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
806 SOUTHEAST CROSSING LANE, GRIMES, IA 50111
(240) 643-4919
Mailing address
806 SOUTHEAST CROSSING LANE, GRIMES, IA 50111
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
—
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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